3D打印肩锁关节模型匹配肩锁钩接骨板治疗急性肩锁关节脱位短期疗效研究  

Short-term efficacy of hook plate under the assistance of 3D Printing Technique on acute acromioclavicular joint dislocation

作　　者：陆建华[1] 陈维凯 罗宗平[2] 周荣[1] 黄永刚[1] 刘滔[3] 杨惠林[3] LU Jianhua;CHEN Weikai;LUO Zongping;ZHOU Rong;HUANG Yonggang;LIU Tao;YANG Huilin(Department of Orthopaedics,Haimen People's Hospital,Nantong 226100,Jiangsu;Institute of Orthopaedics,Soochow University,Suzhou 215006;Department of Orthopaedics,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]江苏省海门市人民医院骨科,江苏南通226100 [2]苏州大学骨科研究所,江苏苏州215006 [3]苏州大学附属第一医院骨科,苏州215006

出　　处：《中华骨与关节外科杂志》2020年第8期652-657,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:肩锁钩接骨板治疗急性肩锁关节脱位,术后疼痛和患肩活动受限临床多见,手术技术直接影响疗效。目的:探讨术前应用3D打印模型匹配肩锁钩接骨板内固定治疗急性肩锁关节脱位的临床优势。方法:2016年1月至2018年12月收治肩锁关节脱位且行肩锁钩接骨板复位内固定韧带修复术患者49例,其中男31例,女18例。年龄30~75岁,平均(49.7±11.3)岁。患者分为3D打印组22例;传统手术组27例。3D打印组术前依据患肩CT扫描数据,3D打印肩锁关节模型,体外模拟复位,匹配合适深度肩锁钩接骨板并塑形,最佳位置固定肩锁关节。记录患者手术情况,术后随访患肩X线检查和功能恢复,评估术后3个月的生活质量和取出接骨板后患肩活动情况。结果:所有患者均获得随访,随访时间6~12个月,平均随访(10.5±2.8)个月。两组患者的手术时间、手术切口长度和术中透视次数比较差异有统计学意义(P<0.05);两组患者术后3个月VAS评分和肩关节Constant评分差异有统计学意义(P<0.05);两组并发症发生率比较差异有统计学意义(P<0.05)。术后6~12个月取出接骨板后两组患肩前屈、外旋、外展、内旋活动范围差异有统计学意义(P<0.05)。结论:3D打印模型辅助切开复位肩锁钩接骨板内固定术治疗急性肩锁关节脱位,手术时间短,切口小,术中X线暴露少,有效规避术后常见患肩疼痛,活动受限等并发症,术后康复满意。Background: In treatment of acute acromioclavicular joint dislocation with hook plate, postoperative pain and activity limitations of the injured shoulder would directly affects the clinic efficacy. Objective: To investigate the clinical advantages of hook plate under the assistance of 3D printing model in treatment of acute acromioclavicular joint dislocation. Methods:From January 2016 to December 2018, 49 patients with acute acromioclavicular joint dislocation including 31 males and 18 females were enrolled with the average age of(49.7±11.3) years(range, 30-75 years). All patients were divided into two groups as 3D printing group(n=22) and traditional operation group(n=27). In 3D printing group, the model of acromioclavicular joint was printed individually according to the CT data of injured shoulder before surgery. A reduction was simulated in vitro and a hook plate was chosen to match with appropriate depth and shape. The matched hook plate was then inserted under the acromion to confirm that it could fix the acromioclavicular joint perfectly. The operation situation was recorded. X-ray and functional recovery of shoulder after operation were followed up. The quality of life on 3 months after surgery and range of motion(ROM)of shoulder after removing the plate were evaluated. Results: All patients were followed up with an average time of(10.5±2.8)months(range, 6-12 months). There were significant differences in operation time, incision length and X-ray exposure times between the two groups(P<0.05).There were also significant differences in the VAS scores and the Constant scores between the two groups 3 months after operation(P<0.05). There was significant difference in complication incidence between the two groups(P<0.05). Significant differences were found in the ROM of shoulder flexion, external rotation, abduction and internal rotation between the two groups after removing the plate(P<0.05). Conclusions: Reduction of acute acromioclavicular joint dislocation with hook plate under the assistance of 3D pri

关 键 词：3D打印 肩锁关节脱位 钩接骨板 重建 肩峰下撞击 

分 类 号：R687.4[医药卫生—骨科学]